Surgical instrument for stitching tissues by means of staples

ABSTRACT

A surgical instrument comprises a support body with an open longitudinal channel, in which are respectively superposed the rod of a pusher member and the rod of a staple housing. A replaceable magazine with staples is secured to a head of the staple housing and drives are provided for moving the staple housing and pusher conjointly to clamp the tissue between the magazine and a jaw on the support body and for thereafter displacing the pusher relative to the staple housing to force staples from the magazine into the tissue.

United States Patent 3,59fi89 [72] lnventor Ernest Mikhailovich Akopov[56] Referen es Cited gilsmswavsky pereulok, 9/2, Kv.6, MOSCOW, UNITEDSTATES PATENTS 2,891,250 6/1959 Nirata 227/19 UX gff 233:; 19683,080,564 3/1963 Strekopitov et al 227/19 ux [45] Patemed June 19713,252,643 5/1966 Strekopitov et al 227/19 X [32] Priority sepL 19673,275,211 9/1966 Hirsch et al 227/19 X [33] U.S.S.R. PrimaryExaminer-Granville Y Custer, Jr. [31 1184885 Att0rney-Waters, Roditi,Schwartz & Nissen ABSTRACT: A surgical instrument comprises a supportbody SURGICAL NSTRUMENT FOR STITCHING with an open longitudinal channel,in which are respectively TISSUES BY MEANS OF STAPLES 8 Claims, 16Drawing Figs.

[52] US. Cl 227/153,

227/19 [5 1] Int. Cl 825C 5/02 [50] Field of Search 227/19 superposedthe rod of a pusher member and the rod of a staple housing. Areplaceable magazine with staples is secured to a head of the staplehousing and drives are provided for moving the staple housing and pusherconjointly to clamp the tissue between the magazine and a jaw on thesupport body and for thereafter displacing the pusher relative to thestaple housing to force staples from the magazine into the tissue.

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PATENTEU JUN29 I97l SHEET 1 BF 4 FIG. 7

PATENTEU JUNZ IBH 3,589,589

' SHEEI h 0F 4 FIG. 15

SURGICAL INSTRUMENT FOR STITCIIING TISSUES BY MEANS OF STAPLES Thepresent invention relates to surgical instruments for stitching tissuesby means of staples, and is designed for momentary suturing of tissuesand organs with lateral and iongitudinal disposition of the stitchese.g. when stitching a bronchial stump, lungs or other organs and tissuesduring surgical operations. 7

Instruments for stitching tissues by means of staples are known in theprior art (see, for example, the US. Pat. .No.

These instruments usually comprise a support body with a longitudinalslot; a perforated jaw for deforming staples; the said jaw being mountedon the said support body; a staple housing having a head and a rod (therod is provided with a longitudinal aperture and mounted in thelongitudinal slot of the support body); a replaceable magazine loadedwith staples and mounted in the head of the staple housing; the saidmagazine being fixed against displacement in the lateral andlongitudinal directions; a pusher with ahead for forcing out the staplesfrom the magazine and with a rod which is placed into a longitudinalguide aperture of the staple housing rod at the side of thestaplehousing head; a screw drive of the staple housing and a lever drive ofthe pusher provided with a stop spring; a fixing device preventingaccidental rejectionof the staples from the magazine; and a handle forholding the instrument.

The principle of stitching tissues by this instrument consists in thatthe staples charged into the magazine are forced out by the pusher andafter piercing the tissues converted into stitches of a surgical suturewith the aid of a perforated jaw.

However, the prior art instruments are complicated in assembling anddisassembling. During the assembling, for example, the pusher rod is tobe introduced through the head of the staple housing into the elongatedlongitudinal guide aperture in the staple housing rod having a smallcross section and a length which considerably exceeds the working strokeof the pusher. Thereafter, the staple housing is mounted in thelongitudinal slot of the supporting body, then the staple housing andpushermust be coupled with the movable component of the pusher drive(for example, with a movable hand of a lever drive), for which purposethe working end of the handle must be introduced intothe'a'perture ofthe pusher rod through a small hole provided in the staple housing.Thereupon the movable handle is fixed in the initial position by turningthe stop abutment. (Disassembling of the instruments is carried out inreverse sequence).

The presence of deep and blind holes and slots in the components of theknown instruments, for example, in the staple housing or the handles ofthe pusher lever drive is disadvantageous in that the cleaning andsterilizating of the instruments is rendered inconvenient and difficult.These deep and blind holes .result in a considerable complication of theprocess of manufacture of thecomponents of the instruments, thusincreasing the cost of production.

Moreover, the prior art instruments with a constant pusher needindividual adjustment of the replaceable magazines 7 because ofconsiderable errors in the mutual positioning of the magazine and thepusher head in the lateral direction due to the fact that the magazineand pusher are mounted in the staple housing independently of eachother. Such an arrangement precludes the possibility of using single-useplastic magazines and increases the cost of production.

The prior art instruments are also inconvenient in handling because theyneed a special fixing device to stop the pusher mechanism. For example,if the movable handle of the pusher lever drive used for holding theinstrument is not stopped in the initial position during the operationit may turn relative to the stationary handle of the instrument andactuate the pusher to reject the staples into the incision.

Furthermore, the instruments heretofore known have components subject tofailure and breakdown, for example, small members of the fixing deviceand flat springs.

The principal object of the present invention is to provide a medicalinstrument, simple in construction and reliable in operation, forstitching tissues by means of staples which can be quickly assembled anddisassembled through simple and convenient manipulations. The componentsof the instrument do not have deep and blind holes and slots. Thefitting of the magazine in the instrument with a constant pusherprovides for the possibility of using replaceable magazines. Accordingto this and other objects, the invention contemplates application of asurgical instrument for stitching tissues by means of staples, whichinstrument incorporates a support body with an open-type longitudinalchannel; a jaw secured to the support body; a staple housing and apusher mounted in the above-mentioned channel for displacement; amagazine with staples secured to a head of the staple housing; drivesforactuating the staple housing and pusher for clamping the tissues to bestitched and for forcing out the staples from the magazine and, wherein,according to the invention, the staple housing and the pusher aresuperposed, one being mounted at the bottom of the channel, the otherbeing placed thereabove, the aforesaid components being adaptable forseparation in the lateral direction.

In order to provide interchangeability of the magazines, it is advisableto mount the magazine on the pusher head to prevent lateraldisplacements of the magazine and on the staple housing head to preventrelative longitudinal displacements.

The staple housing and the pusher are preferably provided with rodsshaped as'bars of a rectangular cross section, which bars are in contactwith the sidewalls of the longitudinal channel in the support body.

The head of the staple housing is preferably provided with a slot whoseopening receives the pusher.

The support body and the upper rod mounted on the lower rod and enteringthe slot of the supporting body are preferably provided with commonlongitudinal guides whose length is approximately equal to the workingstroke of the upper rod.

It is expedient to use screw mechanisms with parallel axes as drives ofthe staple housing and pusher, a handle of the pusher drive beingmovably connected to its rotary component.

Given hereinbelow is a detailed description of an embodiment of thepresent invention, taken in conjunction with the accompanying drawing,in which:

FIG. 1 is a side elevational view of the instrument according to theinvention; I

FIG. 2 is a plan view of the instrument according to the invention;

FIG. 3 is a sectional view of the instrument according to the inventionwith a stitcher unit for suturing organs with a lateral arrangement ofstitches;

FIG. 4 is a cross-sectional view of the instrument according to theinvention taken on the line lV-IV, of FIG. 3;

FIG. 5 is an enlarged diagrammatic view of the staple groove and thepusher plate, according to the invention;

FIG. 6 is a sectional view of the instrument according to the invention,taken on the line VI-VI of FIG. 3;

FIG. 7 is a sectional view of the instrument according to the invention,taken on the line VII-VII of FIG. 3;

FIG. 8 is a sectional view of the instrument according to the invention,taken on the line VIII-VIII of FIG. 3;

FIG. 9 is a sectional view of the instrument according to the invention,taken on the line IX-IX of FIG. 3;

FIG. 10 is a sectional view of the stitcher unit of the instrumentaccording to the invention for suturing organs in a double-rowlongitudinal arrangement of the stitches;

FIG. 11 is a sectional view of the instrument, according to theinvention, taken on the line XI-Xl of FIG. 10;

FIG. 12 is a rear view of the magazine of the instrument, according tothe invention, with a double-row longitudinal arrangement of the staplegrooves;

FIG. 13 is a sectional view of the instrument, according to theinvention, taken on the line Xlll-Xlll of FIG. 12;

FIG. 14 is a plan view of the pusher comb of the stitcher unit of theinstrument according to the invention, for suturing organs with alongitudinal arrangement of the stitches;

H0. 15 is an enlarged cross-sectional view of the magazine and thepusher plates of the stitcher unit for suturing organs in a double-rowlongitudinal arrangement of the stitches, according to the invention;and

FIG. 16 shows an exploded view of the instrument according to theinvention.

Due to the fact that instruments of this type are basically employed formaking sutures of two types, i.e. with a longitudinal or lateralarrangement of stitches, two modifications of stitcher units of theinstrument have been proposed. The difference between thesemodifications, however, is not significant to the principal concept ofthe invention.

The surgical instrument for stitching tissues by means of staples(FIG. 1) comprises a supporting body 1, a perforated jaw 2 secured tothe supporting body, a staple magazine 3, reciprocably movable staplehousing 4, a pusher 5, a nut 6 for a screw drive of the staple housing,a nut 7, a handle 8 for holding the instrument and a limiter 9 forfixing the tissues to be stapled between the jaw 2 and magazine 3 duringtheir clamping.

The support body 1 has an open longitudinal channel 10 with a bottom 11and sidewalls 12. The pusher is installed on the bottom 11 of thechannel 10, the staple housing 4 being mounted above the pusher S. Thebottom 11 has an opening 13 at the rear portion of the supporting body 1for passage of handle 8 for holding the instrument. The sidewalls 12 ofthe channel of the support body have pairs of longitudinal guide grooves14 and 15 whose length is approximately equal to the working stroke ofthe staple housing 4 which, in turn, corresponds to the distance betweenthe two positions of the staple housing 4 within the supporting body 1.The first, initial working position is defined by the gap between thejaw 2 and the magazine 3 suitable for receiving the tissues or organs tobe stitched between the jaw and the magazine prior to the clamping ofthese tissues or organs. The second, final working position of thestaple housing 4 in the supporting body 1 is defined by a minimumstitching gap between the jaw 2 and the magazine 3 corresponding to theleast possible thickness of the clamped tissues. The guide grooves 15have lateral walls 16 (FIGS. 1, 2) for limiting the stroke of the staplehousing 4 upon reaching the minimum stitching gap.

In the rear portion, the support body 1 is limited by a lateral wall 17having an open slot 18 into which is inserted the nut 6 of the drive ofthe staple housing 4.

The staple housing 4 includes a head 19, a rod 20 and a screw 21 rigidlyconnected together, the axis of the screw 21 being parallel to that ofthe rod 20. The housing 4 further includes a yoke 22 with lugs 23 facingthe pusher 5 and two pairs of guide projections 24 and 25 The head 19 ofthe staple housing 4 has a through slot 26 open both at the side of themagazine 3 and at the side of the pusher 5. The pusher 5 is introducedinto the lower portion 26 of slot 26 from below. Cheeks 27 of the head19 of the staple housing 4 are provided with L-shaped slots 28 (FIG. 1)for holding the magazine 3 in the longitudinal direction. The checks 27also have longitudinal slots 29 (FIG. 4) for holding the limiter 9.

The rod 20 of the staple housing 4 is a solid bar with a rectangularcross section. It has a transverse window 30 with a wall 31 for limitingthe stroke ofthe pusher 5 and a pin 32 with a head. The limiter 9 isguided by engagement in the slots 29 in the head 19 of the staplehousing 4 and by engagement with the head of pin 32.

The staple housing 4 is placed together with the pusher 5 and the nut 6and inserted into the supporting body 1, the guide projections 24, 25being opposite the slots 14 and 15 of the supporting body 1 in thisposition. The connection of the supporting body 1 and the staple housing4 and pusher 5 is made nondetachable in the direction of thelongitudinal channel 10 of the supporting body 1, by displ icing thestaple housing 4 a small distance from the initial p( sition to advancethe projections 24, 25 into the grooves 14, 15 of the supporting body 1.ln this case, the projections 24, 25 of the staple housing 4 enter theguide grooves 14, 15 of the supporting body 1 and secure the staplehousing 4 and p usher 5 between the upper surfaces 33, 34 of the grooves14, 15 and the bottom 11 of the longitudinal channel 10.

The guide projections 25 of the staple housing 4 limit the stroke of thestaple housing 4 by bearing against the lateral walls 16 of the guidegrooves 15 in the supporting body 1.

The pusher 5 comprises a head 35 and a rod 36 rigidly connectedtogether. The rod 36 is rigidly connected to the handle 8 which carriesa screw 37 having an axis parallel to that of the screw 21 of the staplehousing 4, An abutment 38 is secured to rod 36 and is engaged in window30 of housing 4 to limit the extreme working position of the pusher 5 byengagement with the wall 31 of the window 30.

The head 35 is made in the form ofa monolithic plate with a solidworking face 39 for the simultaneous expulsion of all the staples fromthe magazine when the instrument if to be used for stitching tissueswith a lateral arrangement of the stitches.

The rod 36 of the pusher has a square cross section and its width isequal to the width of the rod 20 of the staple housing 4, said widthbeing equal to the width of the channel 10 in the supporting body 1 sothat the rod 36 and the rod 20 contact the walls 12 of the channel 10and are guided by these walls in a horizontal plane. The bottom 11 ofthe channel 10 and the lower surface of the rod 20 guide the pusher 5 ina vertical plane when the pusher moves along the channel 10 to force thestaples out of the magazine 3.

The nut 6 of the drive of the staple housing 4 is screwed on the screw21 and an annular groove 40 in nut 6 is engaged in slot 18 in lateralwall 17 of the supporting body 1. Such a position of the nut 6 ensuresthe provision of a gap 41 in the longitudinal direction between thecheeks 27 of the head 19 of the staple housing 4 and the supportingbody 1. This gap compensates for possible manufacturing errors of thenut 6, support body 1 and staple housing 4.

The nut 7 of the pusher drive is screwed on the screw 37, the lugs 23 ofthe yoke 22 of the staple housing entering the annular groove of the nut7 from above.

The nut 7 of the drive of the pusher 5 is pivotally connected by an axle43 to the handle 44 of the drive of the pusher 5. In the nonoperatingposition, the handle 44 is positioned as shown in solid lines in FIG. 3and this allows for compact arrangement of the drives of the staplehousing 4 and pusher 5 and convenient control of these drives inparallel disposition of the screw mechanisms of the instrument.

In order to prevent an accidental ejection of the staples from themagazine 3, the nut 7 of the pusher drive is locked so as to preventturning. The movable handle 44 of the nut 7 of the drive of the pusher 5is used for this purpose. When depressed, the handle 44 enters a recess45 in the handle 8 and the walls of the recess prevent the handle 44from turning about the axis of the screw mechanism of the pusher 5. Theuse of the handle 44 and nut 7 for fixing the pusher 5 againstaccidental displacements precludes the need of a special locking deviceas used in the known instruments.

In the fixed position of the handle 44, a space 46 is formed between theface of the nut 7 and the flange of the screw 37, and a space 47 isformed between the head 35 of the pusher 5 and the head 19 of the staplehousing 4. These spaces are provided to compensate for possible errorthat may occur in manufacturing the staple housing 4, the pusher 5, andthe nut 7 of the pusher 5 in the longitudinal direction. This makes itpossible to manufacture the nut 7 as an interchangeable component and tolower the requirements of the accuracy of manufacture of the staplehousing 4 and the pusher 5.

The operating position of the handle 44 is shown in FIG. 3 in dottedlines. The handle is fixed in this position by the wall 48 of the slot49 of the nut 7, whereas in the initial position it is fixed by theinclined walls 50 of the slot 49.

The magazine 3 for suturing tissues with a lateral arrangement ofstitches is designed in the form of a frame with aper tures 51 (FIGS. 3,4) and the magazine is fitted to the head 35 of the pusher 5, for whichpurpose the depth of the magazine 3 exceeds the depth of the staplescharged into the magazine. Therefore, a projecting portion of themagazine 3 at the rearward end serves for fitting the magazine 3 on head35 to fix the magazine 3 in the lateral direction. In order to providequick and convenient removal of the magazine 3 from the head 35,

the magazine 3 has a bevel 52 and a projection 53 on the 4 upper lateralwall ofthe aperture 51.

For fixing the magazine 3 in the longitudinal direction, lugs 54 areprovided on the magazine for entering the L-shaped slots 28 in thecheeks 27 of the head 19 of the staple housing 4. Constructive gaps areprovided between the lugs 54 of the magazine 3 and the slots 28, whilebetween the lateral walls of the magazine 3 and the cheeks 27 of thehead of the staple housing there are provided gaps 56 compensating forthe er rors of the mutual disposition of the pusher head and the head ofthe staple housing in the transverse direction.

The legs of the staples (not shown on the drawings) are in serted intothe paired grooves 57 (FIG. 5) of the open staple slots in the oppositelongitudinal walls of the magazine 3, the backs of the staples being inthe plane of the apertures 51 in the magazine 3.

In order to ensure the reliable fixing of the magazine 3 rela tive tothe jaw 2, the magazine 3 is provided in the lateral direction withopen-type staple slots whose longitudinal walls 58 are not solid butprovided with additional windows 59, whereas the pusher head is equippedwith plates 60 whose thickness exceeds the width of the staple slots.The plates 60 enter the windows 59.

In the case ofa lateral arrangement of the staple slots in the magazine,the additional windows 59 are combined into a single through port 51common for all the slots of the magazine (FIG. 4), whereas the separateplates 60 (FIG. 5) of the pusher are combined into the single monolithichead 35 of the pusher 5 (FIG. 3) with the solid flat working face 39.Such a construction of the magazine 3 and head 35 as well as the reliability of fixing the magazine 3 relative to the jaw 2 and of forcingout the staples from the magazine make it possible to eliminate anyunfavorable effect of errors due to the incorrect mutual disposition ofthe slots and plates in the case of separate plates, corresponding toeach staple slot, upon the interchangeability of the magazines.

The stitcher unit of an instrument for suturing tissues with adouble-row longitudinal arrangement of stitches with the rows displaced,comprises a jaw 61 (FIG. l0, 11), a magazine 62 and a pusher head 63which are somewhat modified as compared with the above-describedconstruction due to the specific features of the double-row arrangementof the staple slots. However, the construction of the magazine installedon the pusher head as well as that of the whole instrument is substantially the same.

Staple slots 64 in the magazine 62 are of open type similar to those inthe magazine 3 (FIG. 3) in their lateral arrangement. The rear part ofthe magazine 62 is provided with a special aperture 65 for fitting themagazine on the pusher head 63 (FIG. The walls 66, 67 (FIGS. 12, I3) ofthe magazine aperture are in the same plane as the external walls of theauxiliary windows of the extreme staple slots 64 and serve as guideswhen mounting the magazine on the plates 68 of combs 69 of the pusherhead 63.

The pusher head 63 is rigidly connected to the pusher rod 36 andconsists of a holder 70 which is rigidly secured to two combs 69 havingan identical construction but reversed relative to each other inaccordance with the disposition of the staple slots 64 in the magazine.The plates 68 of the combs 69 have a rectangular cross section andcorrespond to the auxiliary windows of the staple slots overlapping thelatter by the thickness. In order to eliminate the effect of the errors,caused by incorrect mutual disposition of the magazine slots and theplates of the pusher head, upon the interchangeability of the magazinesit is advisable to provide constructive gaps 72 between the walls of theauxiliary windows 71 of the magazine slots and the plates 68 which donot lay in a common plane with the basic matched walls 66 and 67 of themagazine aper ture. To provide convenient removal of the magazine 62from the pusher head, the magazine 62 is equipped with a bevel 73 and aprojection 74 on the upper lateral wall of the aperture 65 (FIG. 10).

The limiter 9 is made in the form of a bent strip with a through slot 75and a hole 76 corresponding to the size of the head of the guide pin 32of the staple housing 4. It is slidably mounted on the staple housing 4and its front end 77 is fixed in the lateral directions by the slots 29of the staple housing head and by the slot 75 is fixed by the head ofguide pin 32 (FIG. 3).

The front end 77 of the limiter 9 is provided with a recess 78, whilethe other end 79 of the limiter 9 is upwardly bent for providingconvenient movement of the limiter 9 along the staple housing 4. In theinitial position, the limiter 9 occupies the extreme right-hand positionin FIGS. 1 and 2 while in the working position, it occupies the extremeleft-hand position as shown in FIG. 3.

The operation of the instrument, its assembly and disassembly aredescribed below in conformity with the stitcher unit for suturingtissues with the lateral arrangement of the stitches. All theseoperations may also be related to the instruments with a stitcher unitfor suturing tissues with longitudinal arrangement ofthe stitches.

The instrument operates as follows:

The tissues to be stitched are placed between the jaw 2 and the magazine3 and are clamped in this space by moving the limiter 9 with the aid ofthe bent end 79 in the direction of the jaw 2. On turning the nut 6, thestaple housing 4 with the magazine 3 and the pusher 5 is moved towardsthejaw 2 and a stitching gap corresponding to the thickness of thetissues to be stitched is formed between the jaw 2 and the magazine 3.

Thereafter, the handle 44 of the drive of the pusher 5 is moved to theworking position by turning it about the axle 43 until it bears againstthe wall 48 of the slot 49 of the nut 7. The pusher 5 is moved towardsthe jaw 2 upon turning of the handle 44 about the axis of the nut 7 upto the rest. The head 35 of the pusher 5 forces the staples out from themagazine 3 (the staples are not shown in the drawings). The staplespierce the tissues and with the help of the perforations of the jaw 2are crimped into stitches ofa surgical suture.

After the stitching operation, the limiter 9 is moved rearwardly to itsinitial position and the movable handle 44 is depressed. To remove theinstrument from the stitched tispose the nut 6 is rotated in thedirection opposite to the working direction.

DISASSEMBLY OF THE INSTRUMENTS During disassembly, the nuts 6, 7 are setto their initial positions by rotating them up to the rest in thedirection opposite to the working stroke, the handle 44 of the pusherdrive being introduced into the slot 45 of the handle 8 for holding theinstrument, and the limiter 9 being displaced to its initial position.Then, the head 19 of the staple housing is engaged by two fingers of onehand and the projection 53 of the magazine 3 is forced downwardly andforward with the forefinger of the other hand, the lugs 54 of themagazine 3 being withdrawn from the L-shaped slots 28 of the head 19 ofthe staple housing 4, and the magazine 3 is removed from the instrument.Thereafter, the staple housing 4 and the pusher 5 are removed from theopen channel 10 of the supporting body 1 and the nuts 6 and 7 areunscrewed, the handle 44 being first disengaged from the handle 8.

By displacing the limiter 9 forwards, the opening 76 is coincided withthe head of the guide pin 32 of the staple housing and, by lifting thebent end 79, the limiter 9 is disconnected from the guide pin 32,whereas displacement of the limiter in the rearward direction removes itfrom the grooves 29 of the head of the staple housing.

ASSEMBLY OF THE INSTRUMENT The assembly of the staple housing 4 with thenut 6 and limiter 9 as well as of the pusher S with the nut '7 iseffected in the reverse sequence of disassembly. The pusher is thenapplied against the staple housing 4 and positioned between the cheeksof the head 19 of the staple housing 4, whereas the annular groove 42 ofthe nut 7 of the pusher drive enters the yoke 22 of the staple housing4, and the housing 4 and pusher 5 are together inserted into the openchannel 10 of the supporting body 1, the annular groove 40 of the nut 6being engaged in slot 18 in the wall of the support body 1. Thereafter,the magazine 3, by its fitting aperture 51, is installed on the head 35of the pusher 5. In this case, the head 19 of the staple housing 4 issomewhat removed from the head 35 of the pusher 5 in the directiontowards the channel 10 and is closed by the L-shaped slots 28 of thehead 19 of the staple housing 4, which operation is effectedautomatically during the lowering of the head 19 of the staple housing4. By rotating the nut 6 one turn, the lugs 24, 25 are engaged in theguide grooves 14, of the support body 1. Now the instrument is ready foroperation.

The advantages of the present invention consist in simple constructionof the instrument and reliability in operation. The instrument is verysimple to control as well as in assembly and disassembly whichoperations are carried out through simple manipulations. Therefore, itcan easily be serviced by medical personnel having no special technicaltraining. The instrument ensures interchangeability of the magazines andthis makes it possible to use both the permanent metal magazines andplastic magazines suitable only for single use. The components of theinstrument have no blind, nor inaccessible slots and apertures. Thisprovides for convenience and simplicity in cleaning and sterilizing theinstrument, improved technology of its manufacture, and reduce the costof production. The instrument has no tiny (easy to lose) and breakablemembers so that it provides for a long service life.

It will be obvious to those skilled in the art that various changes andmodifications may be made in the invention without departing from thespirit and scope thereof, and therefore the invention is not limited bythat which is shown in the drawings and described in the specification.

These changes and modifications are considered to fall within the scopeof the present invention as defined by the ap pended claims.

What I claim is:

l. A surgical instrument for stitching tissues by means of staples,comprising a support body with an open longitudinal channel; a jaw onsaid support body; a staple housing with a head, said staple housingbeing mounted in said longitudinal channel for longitudinal displacementtherein, a pusher with a head, said pusher also being mounted in saidlongitudinal channel for displacement therein, said staple housing andsaid pusher being superposed with one thereof placed at the bottom ofsaid channel, said staple housing and pusher being separable intransverse direction; a replaceable magazine with staples secured to thehead of said staple housing, first drive means for moving said staplehousing and said pusher to clamp tissue between said jaw and saidmagazine on the head of the staple housing, and second drive means fordisplacing the pusher relative to the staple housing to force thestaples from said magazine into the tissue, said first and second dri emeans respectively including screw mechanisms arranged parallel to oneanother, one of said drive means including a handle movably andpermanently connected to the rotary component of its screw mechanism.

2. A surgical instrument as claimed in claim 1, comprising meansmounting the magazine on the pusher head to prevent relative transversedisplacement thercbetween and on the staple housing so that relativemovement between the magazine and the staple housing is prevented.

3. A surgical instrument as claimed in claim 1, wherein the staplehousing and pusher include respective rods having rectangular crosssections and contacting the walls of the longitudinal channel of thesupport body.

4. A surgical instrument as claimed in claim 1, m which the head of thestaple housing is provided with an open slot, said head of the pusherbeing slidably inserted into said slot.

5. A surgical instrument as claimed in claim 3, in which the supportbody and the rods of the staple housing and the pusher arranged in saidlongitudinal channel thereof include longitudinal guides whose length isapproximately equal to the relative displacement of the rods in aworking stroke.

6. A surgical instrument as claimed in claim 1, in which the rotarycomponent of the second dr ve means comprises a fixing device preventingturning of said rotary component when the pusher is in an initialinoperative position.

7. A surgical instrument as claimed in claim 3, comprising a handle forholding the instrument secured to the rod of said pusher.

8. A surgical instrument as claimed in claim 7, in which said handle ofsaid one drive means is pivotally connected to the rotary component ofits screw mechanism, said handle for holding the instrument having arecess in which the handle of said one drive means is engaged, in aninitial inoperative position of the pusher, to prevent turning of therotary element of the screw mechanism associated with said one drivemeans.

1. A surgical instrument for stitching tissues by means of staples,comprising a support body with an open longitudinal channel; a jaw onsaid support body; a staple housing with a head, said staple housingbeing mounted in said longitudinal channel for longitudinal displacementtherein, a pusher with a head, said pusher also being mounted in saidlongitudinal channel for displacement therein, said staple housing andsaid pusher being superposed with one thereof placed at the bottom ofsaid channel, said staple housing and pusher being separable intransverse direction; a replaceable magazine with staples secured to thehead of said staple housing, first drive means for moving said staplehousing and said pusher to clamp tissue between said jaw and saidmagazine on the head of the staple housing, and second drive means fordisplacing the pusher relative to the staple housing to force thestaples from said magazine into the tissue, said first and second drivemeans respectively including screw mechanisms arranged parallel to oneanother, one of said drive means including a handle movably andpermanently connected to the rotary component of its screw mechanism. 2.A surgical instrument as claimed in claim 1, comprising means mountingthe magazine on the pusher head to prevent relative transversedisplacement therebetween and on the staple housing so that relativemovement between the magazine and the staple housing is prevented.
 3. Asurgical instrument as claimed in claim 1, wherein the staple housingand pusher include respective rods having rectangular cross sections andcontacting the walls of the longitudinal channel of the support body. 4.A surgical instrument as claimed in claim 1, in which the head of thestaple housing is provided with an open slot, said head of the pusherbeing slidably inserted into said slot.
 5. A surgical instrument asclaimed in claim 3, in which the support body and the rods of the staplehousing and the pusher arranged in said longitudinal channel thereofinclude longitudinal guides whose length is approximately equal to therelative displacement of the rods in a working stroke.
 6. A surgicalinstrument as claimed in claim 1, in which the rotary component of thesecond drive means comprises a fixing device preventing turning of saidrotary component when the pusher is in an initial inoperative position.7. A surgical instrument as claimed in claim 3, comprising a handle forholding the instrument secured to the rod of said pusher.
 8. A surgicalinstrument as claimed in claim 7, in which said handle of said one drivemeans is pivotally connected to the rotary component of its screwmechanism, said handle for holding the instrument having a recess inwhich the handle of said one drive means is engaged, in an initialinoperative position of the pusher, to prevent turning of the rotaryelement of the screw mechanism associated with said one drive means.